India Merchandising Services
India Merchandising Services		 India Merchandising Services
Home India Merchandising Services Our Founder India Merchandising Services About Opjems India Merchandising Services Op jindal Group India Merchandising Services Contact Us India Merchandising Services Faq's India Merchandising Services
India Merchandising Services
India Merchandising Services India Merchandising Services India Merchandising Services
Photo Gallery | OPJEMS Scholars 2007 - 2008 - 2010 - 2011 - 2012
Home » Registration Form

 Registration Form

INSTRUCTIONS:
  1. Please fill in the desired information clearly for all the fields.
  2. Please provide complete details for all mandatory fields.
  3. The fields with * are mandatory.
  4. You will need to attach a recent passport size photograph of yourself.
  5. To fill up the registration form you need to be nominated by your institution.
Personal Details
First Name * :
 Middle Name :
 Last Name * :
Gender *:  Male
 Female		 Date of Birth * :
Calendar
Country * :
Browse your photo
Academic Details
Institute * :
 Discipline/Stream * :
Year of Study *(1/2/3/4) :  
Current Address
Address 1 * :
 Address 2 :
Address 3 : City * :
State * : Pin Code * :
Permanent Address
Address 1 * :
 Address 2 :
Address 3 : City * :
State * : Pin Code * :
Contact Details
Mobile No. * :
 Landline No. :
Mobile No.
(Father/Mother). * :		 Email ID * :
Family Information
Fill in the following details :
Family Member
 Name Profession Qualification
Father :

Mother :

Students Educational Qualification
Degree
 From (Year) To (Year) Name of the Institute and location Board / University Major subjects Percentage Obtained/ CGPA
Class X *:
Class XII * :
Graduation *:
(If you are a 1st year graduate student, you can leave the “overall percentage obtained” column blank)
Post Graduation *:
(If you are a 1st year post graduate student, you can leave the “overall percentage obtained” column blank)
Explain breaks (if any) in your Education :
Name of Scholarship Year Scholarship Amount


Hobbies And Extracurricular Activities (Sports/Music/Theatre Etc.)
Area
 Level
(School / College / State / District / Country / Other)		 Achievement Time Period
(mention the years that you were associated with this area)
From (year) To (year)

Positions of Responsibility Held
Institute / School
 Position Held Time Period
From (year) To (year)

Note : I hereby declare all the information provided in this application are true, complete and correct to the best of my knowledge and belief.

Full Name
 Date Place
Enter the code shown on image:







Home | Our Founder | About Opjems | Op jindal Group | Contact Us | Faq's
Member IndiaMART.com© O P Jindal Charitable Trust. All Rights Reserved (Terms of Use)
Developed and Managed by IndiaMART InterMESH Limited